I was diagnosed very recently that my aorta was enlaged

Your aorta is a thick, three-layered tube that carries all the blood pumped out of your heart to the rest of your body. An aortic dissection happens when one of those layers—usually the inner layer—tears away from the middle layer, creating a space where blood starts to flow in the wrong place, called a "false lumen." It’s kind of like when the tread starts to peel off a tire but hasn’t completely blown out yet. That separation can be dangerous because it weakens the structure of the aorta and puts you at risk for a full rupture if not treated. It is a life threatening emergency if it happens. But since you know you have an issue, you're not going to let that happen because you're monitoring it and you will deal with it by listening to your thoracic surgeon.

You mentioned that your aorta measured 4.5 “cc” — I’m guessing you meant cm, which is the standard way to measure the diameter of the aorta. A normal descending thoracic aorta is usually around 2.5 to 3.5 cm, so 4.5 cm is definitely enlarged, but it’s not panic territory. Think of it like a garden hose that’s a little over-pressurized but hasn’t burst — it needs watching, but it’s not a 911 call. A finding like this is often totally silent — no symptoms — and it's great that it was caught early. Many of us don’t find out until it's an emergency. You’re ahead of the game.

Now, the “borderline” part means you're near the range where doctors will start tracking it more closely. Most cardiologists or aortic specialists will want to repeat imaging every 6 to 12 months to see if it's stable or growing. Growth rate matters a lot more than just the number. If it’s been the same size for years, that’s a different conversation than if it jumps from 4.5 to 4.9 cm in a year.

You said you're 63 and haven’t had heart issues — that’s good, and it's also why it's so important to check in with a cardiologist now. Ask them if you can see someone who specializes in aortic disease specifically. General cardiologists are great, but this is a niche area, and trust me — the right specialist makes all the difference.

In the meantime, a few tips:

1. Avoid heavy lifting and straining — anything that causes a Valsalva maneuver (like holding your breath and pushing hard) spikes your blood pressure and stresses the aortic wall.

2. Monitor your blood pressure carefully. Lower and stable is the goal.

3. Ask your doctor if genetic testing or screening might be helpful — some aortic issues run in families, even if you’ve never had symptoms. I have all of my kids tested after I had a dissection.

I was 50 when my aorta dissected, and it changed my life in every way. But knowing about this before something happens? That’s power. It gives you the chance to act, track, and protect yourself. You’re not alone in this — a lot of us are walking around with “borderline” aortas. With good imaging, careful monitoring, and lifestyle adjustments, many people live long, full lives without ever needing surgery. Peace.

Just to add to @moonboy comments, the aorta leaves the heart “ascending” and then bends down and “descends “ towards the abdomen, descending aneurysms have more options for repairs than ascending (open heart). Critical size start when the dilation starts approaching 5.0 cm. As Moonboy said, find a cardiologist who is an aortic disease specialist, it makes a huge difference.
Watch your BP, keep yourself active and treat your body well, you want to be in the best shape possible when and if you ever need surgery, again abdominal aneurysms (don’t know where on the descending side yours is) normally can be fixed with less traumatic surgeries than ascending, but surgery after all.
Take care and make sure you get monitored periodically just as Moonboy suggested.
Mine was repaired 5 years ago at 5.2 cm, found after an MTB accident , mine was ascending so I needed Open Heart. Knowing you have it is a blessing as you can monitor and plan.

1,000% Agree.

Thank you for all your knowledge in this area. I truly appreciate your reply. It is scary because it's one of things that can just happen. I'm glad you made through it.

Unfortunately l have to make a correction it is the ascending type of aorta. Which type is worse?

That does make a difference, it is not whether one is worse than the other but the options for repair are significantly different. Currently an ascending aortic aneurysm can only be effectively repaired through open heart surgery, it is the only way to have access to that section. But again, you are still far from the critical size, everything else above applies

My cardiologist appointment is Friday 16th. I wish l could say I'm not worried but I'd be lying. My numbers have changed pretty dramatically in 10 months. In July 2024 my dialation was 4.0cm and 10 months later is is 4.5 cm.
At what point do they recommend surgery. So it has to be open heart surgery? That

Were both measurements done by the same method? Depending how they do it they can get different results, when surgery is recommended depends on a lot of factors, usually when it gets to >5.0, but it depends on your body size, family history, growth rate and other factors, that is why it is important to have a cardiologist that specializes in aortic issues, at 4.5 you should also consult with a thoracic surgeon, someone in a major medical center who has done the operation many, many times. Unfortunately for ascending aneurysms, it would be open heart but don’t get ahead of yourself, consult with the specialists, they will give you all the details and follow their advice.

All the best to you and feel free to continue asking questions, a lot of people in this forum have gone through what you are going through

Thank you for the encouraging words. I know there's a lot of people dealing with sickness and medical issues of their own. I'm just one of many.
Take care

This group is terrific! It helps to know we're not alone and this is the place to get tons of useful information.